Clinical Evidence


Bunions

Evidence pack bunions

Dorset CCG Bunion Policy

Gloucestershire CCG policy

North East Essex CCG Bunion criteria

North East Essex Clinical Priorities policy

South Essex CCGs Bunion criteria

NICE Guidance

* No additional evidence was submitted during the consultation period.

 

Hearing Aids

Evidence Pack Hearing Aids

A systematic review of health related quality of life and hearing aids 2007

AQP audiology service specification

Bone anchored hearing aids 2013

British Academy of audiology direct referral criteria 2009

Consensus on hearing aid candidature and fitting for mild hearing loss with and without tinnitus 

DH adult hearing implementation pack

Draft NICE guidance on hearing loss

Hearing Aid policy North Staffordshire CCG 2015

Hearing Aid use and long term health outcomes

Hearing Loss service specifications

NHS England - Commissioning services for people with Hearing Loss

Interventions to improve hearing aid use in adult auditory rehabilitation

Midlands and Lancashire CSU Equality Assessment Hearing Aid policy

North Staffordshire CCG Commissioning Policy for hearing aids

Stoke on Trent CCG Commissioning Policy for hearing aids mild to moderate

Useful evidence sources for hearing aids and hearing loss

Additional evidence on hearing aids submitted during the consultation period

Evidence submitted by Bliss 2 Hear Blog

Department of Health and NHS England - Action Plan on Hearing Loss

Monitor review of hearing loss services 

NHS England - Commissioning services for people with hearing loss

Outcome of Milton Keynes CCG consultation

A systematic review of health-related quality of life hearing aids: final report of the American Academy of Audiology Task Force on the Health-Related Quality of Life Benefits of Amplication in Adults

Cochrane review - Hearing aids for mild to moderate hearing loss in adults

Cochrane review - Hearing aids for tinnitus in people with hearing loss

NICE management of tinnitus

Current NICE review of hearing loss (adult presentation)

NICE: Mental wellbeing of older people in care homes

Action on Hearing Loss - Hearing Matters report

Staffordshire CCGs consultation

Milton Keynes CCG public consultation

British Academy of Audiology - Guidance on Identifying Non-Routine Cases of Hearing Loss in Adults

British Academy of Audiology - Guidance for Primary Care

EuroTrak UK 2012 survey

A cost-utility analysis of adult group audiologic rehabilitation: Are the benefits worth the cost?

Action on Hearing Loss: Why people with hearing loss or deafness would benefit from an integrated response to long-term conditions

DCAL and Action on Hearing Loss (2013) Joining Up: Why people with hearing loss or deafness would benefit from an integrated response to long-term conditions.

Culhane (2014) All about tinnitus version 1.5. British Tinnitus association.

Ringham (2013) Access all areas: A report into the experiences of people with hearing loss when accessing healthcare

NHS England Accessible Information Standard 2015

Action on Hearing Loss: Hidden Disadvantage Why are people with hearing loss still losing out at work?

Monitor and NHS England: National tariff information workbook 2014/15

Action on Hearing Loss / London Economics (2010) Cost benefit analysis of hearing screening for older people

Abrams et al (2002) A cost utility analysis of adult group audiological rehabilitation: are the benefits worth the costs? Journal of Rehabilitation Research and Development 39(5): 549-558;

Which? website - Hearing Aid prices

Department for Work and Pensions (2014): Family Resources Survey: financial year 2013/14

Health and Social Care Act (2012): Section 26, Clinical commissioning groups: general duties etc.

NHS Constitution for England

NICE quality statement on mental wellbeing of older people in care homes

National Institute of Clinical Excellence (NICE) guidance for Adult onset hearing loss currently in production (expected 2018)

NHS Outcomes Framework – 5 domains resources

The National Health Service (Procurement, Patient Choice and Competition) Regulations 2013

General Medical Council - Good Medical Practice

NHS England (2013) Transforming participation in health and care, September 2013.

Letter from Action Hearing Loss

Action on Hearing Loss (2015) Hearing Matters summarises all the evidence relating to the needs of people with hearing loss

Department of Health and NHS England (2015) Action Plan on Hearing Loss

Which Website 2014

The Ear Foundation (2014) The real cost of adult hearing loss: reducing its impact by increasing access to the latest hearing technologies

Murray CJ, et al. UK health performance: findings of the Global Burden of Disease Study.

NICE. Guide to the methods of technology appraisal 2013

World Health Organisation - Grades of hearing impairment

Bliss 2 Hear Blog - The importance of hearing aids

Bliss 2 Hear blog - Say no to speech fog

Bliss 2 Hear blog- Manage without hearing aids

Department of Health & NHS England Action Plan on Hearing Loss (23rd March 2015)

Negative consequences of uncorrected hearing loss - A review

The Hearing Review: Auditory Deprivation, Brain Changes Secondary to Hearing Loss, and More: An Interview with Anu Sharma, PhD

Age UK - Study highlights hearing loss and dementia link

Action on Hearing Loss: The Importance of Hearing Aids - Getting the message across to CCGs

Phonak audiology blog - What does big data tell us about hearing aid use in adults with mild hearing loss?

Action on Hearing Loss - How is your hearing?

Additional evidence and comments

  • "There is much research that shows that hearing loss is linked to other conditions, such as depression, mental health issues and dementia for example.  There are many studies showing this but see Lin FR, Metter EJ, O’Brien RJ, Resnick SM, Zonderman AB, Ferrucci L. Hearing Loss and Incident Dementia. Arch Neurol. 2011;68(2):214-220. for example the risk of people with moderate hearing loss is three times higher, and for people with severe hearing loss it is almost five times higher’ (pg. 14. Lin FR, Metter EJ, O’Brien RJ, et al. (2011) ‘Hearing loss and incident dementia’, Archives of Neurology, 68(2): 214-20)."
  • Davis et al (2007) Acceptability, benefit and costs of early screening for hearing disability: A study of potential screening tests and models. Health Technology Assessment 11: 1–294.
  • Ferguson MA, Kitterick PT, Chong LY, Edmondson-Jones M, Barker F,HoareDJ.Hearing aids formild tomoderate hearing loss in adults. CochraneDatabase of Systematic Reviews 2017, Issue 6. Art.No.:CD012023. DOI
  • Chisholm et al (2007) A systematic review of health-related quality of life and hearing aids: Final report of the American Academy of Audiology task force on the health-related quality of life benefits of amplification in adults. Journal of American Academy of Audiology 18: 151-183
  • Lustig and Olson (2014) Hearing Loss and healthy ageing. Institute of Medicine and National Research Council 
  • Perez E and Edmonds BA, 2012. A Systematic Review of Studies Measuring and Reporting HearingAid Usage in Older Adults since 1999: A DescriptiveSummary of Measurement Tools. PLoS ONE 7 (3), e31831
  • Chisolm and Arnold. (2012) Evidence about the effectiveness of aural rehabilitation programs for adults. Evidence based practice in audiology, edited by L. Wong and L. Hickson. Plural Publishing: San Diego
  • Furgeson MA, Brandreth M, Brassington W, Leighton P, Wharrad H, 2016. A randomised control trial to evaluate the benefits of a multimedia educational programme for first time hearing aid users. Ear and Hearing 2016; 27(2): 123-36
  • Chiorba et al (2012) The impact of hearing loss on the quality of life of elderly adults. Journal of Clinical Interventions in Aging 7: 159–163; Chisholm et al (2007) A systematic review of health-related quality of life and hearing aids: Final report of the American Academy of Audiology task force on the health-related quality of life benefits of amplification in adults. Journal of American Academy of Audiology 18: 151-183;Arlinger (2003) 
  • Hogan et al (2009) The health impact of a hearing disability on older people in Australia. Journal of Aging and Health 21(8): 1098–1111; Dalton et al (2003) The impact of hearing loss on quality of life in older adults.
  • The Gerontologist 43(5): 661-668. 
  • World Health Organization (2008) The global burden of disease, 2004 update. 
  • Herbst et al (1990) Implications of hearing impairment for elderly people in London and in Wales.Acta Oto-laryngological.476: 209-214; 
  • Du Feu and Fergusson (2003) Sensory impairment and mental health. Advances in psychiatric treatment. 9: 95-103;
  • Monzani et al (2008) Psychological profile and social behaviour of working adults with mild or moderate hearing loss. Acta Otorhinolaryngologica Italica. 
  • 442-8; Hétu et al (1993). The impact of acquired hearing loss on intimate relationships: Implications for rehabilitation. 
  • Audiology 32(3): 363–81; Gopinath et al (2012) Hearing-impaired adults are at increased risk of experiencing emotional distress and social engagement restrictions five years later. Age and Ageing 
  • Eastwood et al (1985) Acquired hearing loss and psychiatric illness: an estimate of prevalence and co-morbidity in a geriatric setting. British Journal of Psychiatry 147: 552–556; 
  • Saito et al (2010) Hearing handicap predicts the development of depressive symptoms after three years in older community-dwelling Japanese.  Journal of the American Geriatrics Society 58(1): 93-7; National Council on the Aging. (2000)
  • The consequences of untreated hearing loss in older persons. Head & Neck Nursing. 18(1): 12-6; 
  • Genther et al (2013) Association of Hearing Loss With Hospitalization and Burden of Disease in Older Adults- Journal of the American Medical Association 309(22): 2322; 
  • Cooper (1976) Deafness and psychiatric illness. British Journal of Psychiatry 129: 216-226

  • Saito et al (2010) Hearing handicap predicts the development of depressive symptoms after three years in older community-dwelling Japanese. Journal of the American Geriatrics Society 58(1): 93-7 
  • Lin et al. (2011) Hearing loss and incident dementia. Archives of Neurology 68(2): 214-220; 
  • Lin et al (2013) Hearing loss and cognitive decline in older adults. Internal Medicine 173(4): 293-299; 
  • Lindenberger and Baltes (1994) Sensory functioning and intelligence in old age: a strong connection. Psychology and Aging. 9: 339-355;
  • Lindenberger and Baltes (1997) Intellectual functioning in old and very old age: cross-sectional results from the Berlin aging study. Psychology and Aging. 12: 410-432; 
  • Uhlmann et al (1989) Relationship of hearing impairment to dementia and cognitive dysfunction in older adults. Journal of the American Medical Association 261: 1916-1919;
  • Gurgel et al (2014) Relationship of hearing loss and dementia: A prospective, population-based study. Otology & Neurotology 35(5): 775-81; 
  • Deal JA, Sharrett AR, Albert MS, Coresh J, Mosley TH, Knopman D, Wruck LM and Lin FR, Hearing impairment and cognitive decline: A pilot study conducted within the atherosclerosis risk in communities’ neurocognitive study. American Journal of Epidemiology, 2015, 181 (9), 680-690;
  • Lin and Ferrucci (2012) Hearing loss and falls among older adults in the United States. Archives of Internal Medicine 172(4): 369-371; 
  • Viljanen et al (2009) Hearing as a predictor of falls and postural balance in older female twins. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 64(2): 312-7 
  • Appollonio et al (1996) Effects of sensory aids on the quality of life and mortality of elderly people: A multivariate analysis. Age and Ageing 25: 89-96; 
  • Karpa et al (2010) Associations between hearing impairment and mortality risk in older persons: the Blue Mountains Hearing Study. Annals of Epidemiology 20(6): 452-9 
  • Kakarlapudi et al (2003) The effect of diabetes on sensorineural hearing loss. Otology and Neurotology 24(3): 382-386;
  • Mitchell et al (2009) Relationship of Type 2 diabetes to the prevalence, incidence and progression of age-related hearing loss. Diabetic Medicine 26(5): 483-8;
  • Chasens et al (2010) Reducing a barrier to diabetes education: identifying hearing loss in patients with diabetes Diabetes Education 36(6): 956-64 
  • Formby et al (1987)Gopinath et  al (2009) Association between age-related hearing loss and stroke in an older population. Stroke Hearing loss among stroke patients. Ear and Hearing 8(6): 326-32;
  • Chia et al (2006) Association between vision and hearing impairments and their combined effects on quality of life. Archives of Ophthalmology 124(10): 1465-70
  • Rumalla et Al (2015) The effect of hearing aids on postural stability Laryngoscope. 2015 Mar;125(3):720-3. doi: 10.1002/lary.24974. 
  • Davis and El Refaie (2000) The epidemiology of tinnitus. In Tyler (ed.) The Handbook of Tinnitus p1
  • Meikle (2002) Tinnitus: Is it the sound of hearing loss? Tinnitus Today: Journal of American Tinnitus Association. September 2002: 8-11
  • Saltzman (1947) A hearing aid for the relief of tinnitus aurium. Laryngoscope 57: 358 -366;
  • Vernon, (1977) Attempts to relieve tinnitus. Journal of the American Audiology Society 2(4): 124-31;
  • Stacey (1980) Apparent total control of severe bilateral tinnitus by masking, using hearing aids. British Journal of Audiology 14(2): 59-60
  • Surr et al (1985) Effect of amplification on tinnitus among new hearing aid users. Ear and Hearing 6(2): 71-5;
  • Melin et al (1987) Hearing aids and tinnitus-an experimental group study. British Journal of Audiology 21(2): 91-7;
  • Trotter and Donaldson (2008) Hearing aids and tinnitus therapy: a 25-year experience. Journal of Laryngology and Otology 122(10): 1052-6. 
  • Brooks DN, Bulmer D. Survey of binaural hearing aid users. Ear and hearing. 1981, 2 (5): 220-224
  • McKee et al (2011) Perceptions of cardiovascular health in an underserved community of deaf adults using American Sign Language. Disability and Health 4(3): 192-197;
  • Margellos-Anast et al (2006) Cardiovascular disease knowledge among culturally Deaf patients in Chicago. Preventive Medicine 42(3): 235-9 
  • Brooks et al (2001) The effects on significant others of providing a hearing aid to the hearing-impaired partner. British Journal of Audiology 35(3): 165-71; 
  • Desbiens et al (2001) Stress in caregivers of hospitalized oldest-old patients. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 56: 231–235; 
  • Wallhagen et al (2004) Impact of self-assessed hearing loss on a spouse: A longitudinal analysis of couples. Journals of Gerontology: Series B 59(3): S190-S196;
  • Hetu et al (1993) The impact of acquired hearing impairment on intimate relationships: Implications for rehabilitation. Audiology 32(6): 363-381;
  • Boi et al (2012) Hearing loss and depressive symptoms in elderly patients. Geriatrics and Gerontology International 12(3): 440-445; 
  • Stark and Hickson (2004) Outcomes of hearing aid fitting for older people with hearing impairment and their significant others. International Journal of Audiology 43(7): 390-8
  • Tolson et al (2002) Hearing disability: a source of distress for older people and carers. British Journal of Nursing 11(15): 1021-5 
  • Kramer at al (2006) Occupational performance comparing normally-hearing and hearing-impaired employees using the Amsterdam Checklist for Hearing and Work. International Journal of Audiology 45(9): 503-12 
  • Tye-Murray et al (2009) Professionals with hearing loss: maintaining that competitive edge. Ear and Hearing 30(4): 475-84 
  • Link Centre (2005) Hidden Lives. The psychological and social impact of becoming deafened in adult life.
  •  Link Centre: Eastbourne; Jennings and Shaw (2008) Impact of hearing loss in the workplace: raising questions about partnerships with professionals. Work 30(3): 289-95 
  • Access Economics (2006) Listen Hear: The economic impact and cost of hearing loss in Australia. Access Economics, Canberra
  • 76 Morris et al (2013) An economic evaluation of screening 60- to 70-year-old adults for hearing loss. Journal of Public Health 35(1): 139 – 146
  • US Preventative Services Task Force (2012) Screening for hearing loss in older adults: U.S. Preventative Services Task Force recommendation statement. Annals of Internal Medicine. 157(9): 655-661
  • Chao & Chen (2008) Cost-effectiveness of hearing aids in the hearing-impaired elderly: a probabilistic approach. Otology and Neurotology 29(6): 776-83
  • Dawes et al (2014) Hearing in middle age: a population snapshot of 40- to 69-year olds in the United Kingdom. Ear and Hearing 35(3): 44-51; 
  • Davis et al (2008) The relationships between work based noise over the adult life course and hearing in middle age. International Journal of Audiology 47: 100-108; 
  • Sixt and Rosenhall (1997) Presbycusis related to socioeconomic factors and state of health. Scandinavian Audiology 26(3): 133–140 
  • Yueh et al (2001) Randomized trial of amplification strategies. Archives of Otolaryngology -- Head & Neck Surgery 
  • Cacdatore et al (1999) Quality of life determinants and hearing function in an elderly population: Osservatorio Geriatrico Campano Study Group . Gerontology 45 :323-323 ; 
  • Mulrow et al (1990) Quality-of-life changes and hearing impairment. A randomized trial. Annals of Internal Medicine.  113(3):188-94; 
  • Davis et al (2007) Accepta bility, benefit and costs of early screening for hearing disability : A study of potential screening tests and models. Health Technology Assessment 11: 1-294
  • European Hearing Instrument Manufacturers As sociation (2015). Eutrotrak 2015; Perez E and Edmonds BA 2012. 
  • A Systematic Review of Studies Measuring and Reporting Hearing Aid Usage in Older Adults since 1999: A Descriptive Summary of Measurement Tools . PLoS ONE 7 (3), e31831
  • Gopinath et al (2012) Hearing-impaired adults are at increased risk of experiencing emotional distress and social engagement restriction.s five years later. Age and Ageing 41(5): 618-623;
  • Pronk et al (2011) Prospective effects of hearing status on loneliness and depression in older persons : identification of subgroups. International Journal of Audiology, 50 (12), 887-96
  • Saito et al (2010) Hearing handicap predicts the development of depressive symptoms after three years in older community­dwelling Japanese. Journal of the American Geriatrics Society, 58 (1), 93-7; 
  • National Council on the Aging. (2000) The consequences of untreated hearing loss in older persons. Head and Neck Nursing 18(1): 12-6;
  • Acar et al (2011) Effects of hearing aids on cognitive functions and depressive signs in elderly people, Archives of Gerontology and Geriatrics, 52(3): 250- 2;
  • Mulrow et al (1992) Sustained benefits of hearing aids . Journal of Speech & Hearing Research 35(6): 1402-5;
  • Amieva et al (2015) Self-reported hearing loss, hearing aids, and cognitive decline in elderly adults : A 25 year study . Journal of the Amer ican Geriatrics Society 63 (2), 2099-2104
  • Deal et al (2015) Hearing impairment and cognitive decline : A pilot study conducted within the atherosclerosis risk in communities neurocognitive study . American Journal of Epidemiology, 181 (9), 680-90 ; 
  • Albers et al (2015) At the interface of sensory and motor dysfunctions and Alzheimer's disease. Alzeimer 's and Dementia Journal, 11 (1), 70-98
  • Yamada et al (2011) Impact of hearing difficulty on dependence in activities of daily living (ADL) and mortality: A 3-year cohort study of community-dwelling Japanese older adults. Archives of Gerontology and Geriatrics 52(3): 245-249
  • Davis A, Smith P, Ferguson M, Stephens D, Gianopoulos I. 2007. Acceptability, benefit and cost of early screening for hearing disability: a study of potential screening tests and models. Health Technol Assess. 2007; 11(42)
  • Barton GR, Bankart J, Davis AC, Summerfield QA. Comparing utility scores before and after hearing-aid provision : results according to the EQ-5D, HUI3 and SF-6D. Appl Health Econ Health Policy. 2004;3(2):103-5.
  • Swan IR, Guy FH, Akeroyd MA. Health-related quality of life before and after management in adults referred to otolaryngology: prospective national study. Clin Otolaryngol. Feb 2012; 37(1): 35-43
  • Bainbridge K and Wallhagen M.  Hearing Loss in an Aging American Population: Extent, Impact, and Management. Annu Rev Public Health. 2014; 35:139–52
  • Metselaar M, et al.  Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids: comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni and bilateral fittings. Eur Arch Otorhinolaryngol. 2009; 266:907–917
  • Humes, Larry E, Sara E Rogers, Tera M Quigley, Anna K Main, Dana L Kinney, and Christine Herring. 2017. 'The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial', American Journal of Audiology, 26: 53-79.
  • Ferguson MA, Kitterick PT, Edmondson-Jones M, Barker F, Hoare DJ. Hearing aids for mild to moderate hearing loss in adults. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD012023. DOI: 10.1002/14651858.CD012023
  • Ferguson M, Maidment D, Kitterick P, Hoare D, Barker F (2017) Assessing the evidence for the effectiveness of hearing aids and alternative listening devices for adults with hearing loss: two systematic reviews
  • Gatehouse, S. A self-report outcome measure for the evaluation of hearing-aid fittings and services, Health Bulletin, 1999; 57:424-436
  • Parsons J, Mithra C, Ferguson M. (2016) An Investigation into COSI outcomes in NHS hearing aid patients categorized by degree of hearing loss.

  • Lin F, et al. Hearing Loss and Cognitive Decline in Older Adults. JAMA Intern. Med. 2013; 173: 293-99
  • Amieva, H., Ouvrard, C., Guilioli, C., Meillon, C., Rullier, L., & Dartigues, J. (2015). Self-reported hearing loss, hearing aids, and cognitive decline in elderly adults: A 25 year study. Journal of the American Geriatrics Society, 63(2), 2099-2104.
  • Dawes P, et al. Hearing loss and cognition: The role of hearing aids, social isolation and depression. PLoS ONE. 2015.
  • Palmer, C. V., Adams, S. W., Bourgeois, M., Durrant, J., & Rossi, M., 1999. Reduction in caregiver-identified problem behaviors in patients with Alzheimer disease post-hearing-aid fitting. J Speech Lang Hear Res, 42, 312-328
  • Lutman, ME & Spencer H S, Occupational noise and demographic factors in hearing. Acta Otolryngol Suppl, 476, 74-84.
  • Ecob R, et al. Is the relationship of social class to change in hearing threshold levels from childhood to middle age explained by noise, smoking, and drinking behaviour? International Journal of Audiology. 2008. 47: 100-108
  • Taylor W, Pearson J, Mair A, Burns W. Study of noise and hearing in jute weaving.JAcoust Soc Am. 1965;38:113-20.

     

Hernia

Hernia evidence based medicine pack

Cambridge and Peterborough CCG briefing on hernia surgery

Cambridge and Peterborough CCG briefing on hernia policy

Devon CCGs abdominal wall hernia policy

North East Essex CCG - elective surgical repair 

North East Essex CCG - clinical priorities policy

South Central and West CSU and CCGs policy on hernia repair

Watchful waiting vs repair of inguinal hernia in minimally symptomatic men

West Suffolk CCG policy on hernia repair 

* No additional evidence was submitted during the consultation period.

Vasectomy

Vasectomy evidence based medicine pack

Kent and Medway CCG's schedule of policy statements for health care interventions, and referral and treatment criteria

Vale of York CCG vasectomy policy March 2015

Scarborough and Ryedale CCG vasectomy policy March 2015

Harrowgate and Rural District Vasectomy policy

* No additional evidence was submitted during the consultation period.
 

Uterovaginal Prolapse

Uterovaginal prolapse evidence pack

Basildon and Brentwood CCG vaginal uterine prolapse policy

Mid Essex vaginal uterine prolapse policy

North West London CCGs uterovaginal prolapse policy from Hounslow CCG website

 * No additional evidence was submitted during the consultation period.
 

Revision Mammoplasty

Revision mammoplasty evidence pack

Dorset CCG criteria based access protocol - breast surgery

South East London treatment access policy

* No additional evidence was submitted during the consultation period.


Revision of Hypertrophic Scars

Hypertrophic scars evidence pack

A study on scar revision 2016

Hypertrophic scars and keloids article 2009

Ipswich CCG revision of scars policy

North West CSU revision of scars policy 

Scar revision slides 2002-2004

Techniques for scar revision 2006

* No additional evidence was submitted during the consultation period.


Penile Procedures

Penile procedures evidence pack

Devon CCG policy

North East Essex Clinical Priorities Policy 2016

North West London CCG penile implants policy from Hounslow CCG website

* No additional evidence was submitted during the consultation period.


Cholecystectomy for gallstones

AEBM evidence pack cholecystectomy for gallstones

Sandwell and Birmingham CCG policy

Solihull CCG and others - policy on gallstones

* No additional evidence was submitted during the consultation period.


Chalzions (Internal Stye or Meibonian Cyst)

Chalzions evidence pack

College of optometrists chalzions management guidance

North East Essex CCG clinical priorities policy

North West London chalzion policy from Hounslow CCG website

Oxfordshire CCG opthamology referral guidelines

Vale of York PoLCE policy

* No additional evidence was submitted during the consultation period.


Correction of Ptosis

Evidence pack correction of Ptosis

Greater Manchester shared services policy on Ptosis

North West CSU correction of eyelid ptosis policy December 2014

North West London Blepharoplasty and Ptosis from Hounslow CCG

* No additional evidence was submitted during the consultation period.


Knee Replacements

Evidence pack knee replacements

Devon and Cornwall CCGs hip and knee replacement policy

Hull CCG hip and knee replacement policy

Ipswich and East Suffolk CCGs hip and knee replacement policy

North Essex CCG clinical priorities 2016

North West London knee replacement policy from Hounslow CCG website

South Norfolk CCG hip and knee replacement policy

 * No additional evidence was submitted during the consultation period.

Homeopathy

Evidence pack homeopathy

BMJ report on homeopathy and Iscador therapy

Bristol CCG homeopathy consideration 2014

NHS GMMMG homeopathy policy

Government Response to the Science and Technology Committee report 'Evidence Check 2: Homeopathy

Liverpool CCG engagement appendices

Liverpool CCG engagement for homeopathy

Macmillan Cancer Research information on homeopathy

University of York homeopathy report

Wirral CCG homeopathy consultation


New evidence submitted during the consultation

What's the Harm website

Evidence of clinical efficacy of homeopathy – A meta-analysis of clinical trials. Eur J Clin Pharmacol, 2000; 56: 27–33. Cucherat M, et al.

Measure Yourself Medical Outcome Profile

A patient reported outcome measure in homeopathic clinical practice for long-term conditions

NICE qualys

NHS Liverpool CCG Homeopathy Consultation, page 34

Evidence Check 2: Homeopathy - Science and Technology Committee paragraph 78

Evidence Check 2: Homeopathy - Science and Technology Committee Contents

West Kent PCT study

The House of Commons’ Science and Technology Select Committee comments on NHS West Kent’s review of homeopathy

The Australian National Health and Medical Research Council review of the evidence base for homeopathy

NHS Choices website

The Royal Pharmaceutical Society of Great Britain position statement

Good Thinking Society legal challenge

Good Thinking Society Legal Challenge

West Kent PCT memorandum

Honour Watt for judicial review of a decision of Lothian Health Board to withdraw the provision of homeopathic services

Wirral patient stops NHS commissioning decisions being taken in private

Good Thinking Society

NHS Choices Homeopathy

Spectator Health

House of Commons Science and Technology Committee. Evidence Check 2: Homeopathy.

Government Response to the Science and Technology Committee report Evidence Check 2

Australian NHMRC review in detail. HRI. 2014

Homeopathy in Healthcare – Effectiveness, Appropriateness, Safety, Costs

Additional Evidence and Comments

  • Homeopathy is generally regarded as one of the most controversial CAM therapies. It is ironic that 6 systematic reviews or meta-analyses have been conducted, with 5 out 6 of these showing beneficial effects over and above placebo - - Homeopathy systematic reviews or meta-analyses demonstrating a beneficial effect compared with placebo: - (1) Mathie RT, et al. Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis. Syst Rev, 2014; 3: 142.

  • Linde K, et al. Impact of study quality on outcome in placebo controlled trials of homeopathy. J Clin Epidemiol, 1999; 52: 631–6.

  • (5) Kleijnen J, et al. Clinical trials of homeopathy. Br Med J, 1991; 302: 316–23. - - Homeopathy trials revealing no difference from controls:
 - (1) Shang A, et al. Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet, 2005; 366: 726–32. - - Evidence of effectiveness, that relates to the effect in the real world (efficacy relates only to experimental conditions such as those used in RCTs), is often the result of multiple factors, many of which are not measured in a RCT, such as regression to the mean, Hawthorne effect, placebo effect, psycho-social factors, concomitant treatments, etc. - - Use of CAM therapies can empower individuals to take more responsibility for their health and thus reduce the burden on the NHS.

  • The 2006 Swiss technology assessment (HTA) report on homeopathy clearly endorsed the benefit from this form of complementary therapy, stating: "There is sufficient evidence for the pre-clinical effectiveness and the clinical efficacy of homeopathy and for its safety and economy compared with conventional treatment."

  • From an economic standpoint refer to the Faculty of Homeopathy’s “Go Figure: Making the Economic Case for Homeopathy” report (2016) which recommends translation of clinical outcomes into HM Treasury Green Book parlance to better express the debate and reach out to policymakers and stakeholders.

  • Russian Academy of Sciences The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available.

  • National Health and Medical Research Council, Australia Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.

  • Health Canada - These products are not supported by scientific evidence.

  • Nighingale Collaboration - We agree with your proposal to decommission homeopathy services and to add them to your PoLCE policy. Considering the lack of any good evidence for specific effects for homeopathy over placebo, we do not believe it is appropriate for it to be provided by the NHS whether routinely, through an Individual Funding Request, through a Personal Health Budget, through direct payments for healthcare or through any other means. We agree with your conclusion that the funding of homeopathy is not a fair use limited resources.

  • Ioannidis JPA. Why Most Published Research Findings Are False. PLoS Med 2005;2:e124. doi:10.1371/journal.pmed.0020124

  • Gurtner F. The report ‘Homeopathy in healthcare: effectiveness, appropriateness, safety, costs’ is not a ‘Swiss report’. Swiss Medical Weekly Published Online First: 17 December 2012

  • Henness A, Rudloff S. That ‘neutral’ Swiss homeopathy report | Zeno’s Blog. 2012